Pharmacist-led social needs and medication history intervention in the emergency department: A feasibility pilot study

BACKGROUND: Health-related social needs (HRSNs) are common among patients in the Emergency Department (ED) and contribute to poor health outcomes and medication-related problems. Pharmacists may help identify and address these needs during medication history reviews, yet evidence on the feasibility and acceptability of pharmacist-led HRSN screening in the ED is limited. 

OBJECTIVES: To evaluate the feasibility, acceptability, and patient perspectives of a pharmacist-led HRSN screening and referral integrated with medication history review in the ED. 

METHODS: This prospective study was conducted at an academically affiliated tertiary medical center between September 2024 and April 2025. Eligible participants were English-speaking adults aged ≥18 years who presented to the ED and were discharged home. A pharmacist conducted medication histories followed by a modified HRSN screening tool covering four domains: food insecurity, housing instability, transportation barriers, and utility difficulties. Participants who screened positive and requested assistance were provided with personalized list of community resources using the 211 Western New York directory. A follow-up survey was completed within 30 days of discharge. Participants who received referrals also answered questions about resource relevance, outcome, and resolution of needs. 

RESULTS: Of 149 screened patients, 58 enrolled and completed both the medication history and HRSN screening. Pharmacist review identified medication discrepancies in 48.3% of participants. Twenty-three participants (39.7%) reported at least one unmet HRSN, most commonly transportation (25.9%) and food insecurity (22.4%). Eight (13.8%) participants requested referrals. One participant contacted a community resource and resolved their need. Among survey respondents (n=27), 92.6% felt comfortable discussing social needs with pharmacists, and 85.2% supported pharmacist involvement in this work. 

CONCLUSION: Pharmacist-led medication history and social needs screening in the ED is feasible and acceptable to patients. Pharmacists may serve as early identifiers of unmet needs during ED encounters and help link patients to community resources when supported by downstream follow-up.